Archive | Neck Pain RSS feed for this section

Neck Pain and Upper-Crossed Syndrome

16 Nov

In normal head and neck posture, the center of the shoulder joints are located vertically in line with the bottom of the mastoid processes (the bone just behind the bottom of the ear at the base of the skull) while the muscles on the posterior (or back side) of the cervical spine (neck) act to maintain balance and keep the head back.

Sitting at a computer or using a smartphone for long lengths of time can lead to a muscular imbalance—referred to as an “upper-crossed syndrome” (UCS)—where specific muscles in the upper back and neck (upper trapezius and levator scapulae) and the chest muscles (pectorals) are too tight. These hypertonic muscles “cross” with weakness of the deep neck flexors (in the front neck) and middle and lower trapezius (in the mid-back).  This results in the classic forward head posture and rounded shoulders.

Fortunately, forward head posture can be remedied with exercises to strengthen the weak muscles and stretch the overly tight muscles. Here are a few:

  • Perform a standard push-up (from knees or toes) and when in the “up” position, push further toward the ceiling (feel your shoulder blades spread further apart).
  • Lie prone on a bench and raise your arms overhead to form a “Y”; follow with a “T” by lowering the arms to horizontal or 90°; move to a “W” (bend elbows 90° and lower arms to 45°); follow with an “L” (place arms at your sides keeping elbows bent at 90°, rotate outwards the forearms as far as possible). Squeeze your shoulder blades together, DON’T shrug the shoulders, HOLD each position for five to ten seconds and repeat the series two to three times.
  • Tuck your chin inward and nod; add some resistance—using your thumb/index grasping the chin—resist in BOTH directions (down and up nods). As a posture re-trainer, keep your chin-tucked during the day.
  • Lie on your side, elbow bend 90°; use a hand weight and raise it slowly toward the ceiling and lower it back down (five to ten slow reps); repeat on the other side.
  • Stand in a doorway and hook your elbow on (or grasp with your hand) the door jamb; slowly turn your body away from the door jamb until you feel a strong stretch in your chest muscles. Start low and move your elbow/hand higher and repeat; continue upwards until its overhead. Repeat several times on each side.
  • Look down and side bend RIGHT; reach over with your RIGHT hand and gently pull the head to a firm endpoint; reach with the LEFT hand toward the floor. 
  • Look down, side bend, and rotate your head RIGHT; reach over with your RIGHT hand and gently pull the head to a firm endpoint; reach with the LEFT hand toward the floor. REPEAT on opposite side. Hold five to ten seconds and repeat two to three times.

Upper crossed syndrome and forward head posture can also lead to joint fixations in the cervical and thoracic spine, which can be addressed by a doctor of chiropractic using spinal manipulative therapy. Your chiropractor can also walk you through these and other exercises to restore normal posture, depending on your unique case.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Neck Pain and Workstation Options

15 Oct

Neck pain is commonly associated with sitting in front of a computer for prolonged periods of time. So is there a “best” or “ideal” type of desk to use when working at a computer all day?

The sit-stand desk has gained significant popularity in recent years, especially with an 83% increase in sedentary jobs since the 1950s. In a 2018 study, researchers compared the effect of using a sitting and standing desk for 90 minutes among 20 healthy adults. Researchers monitored typing task performance and discomfort, vascular/blood flow, and muscular changes in the neck, shoulders, and arms and found that standing desk use resulted in greater engagement of the shoulder girdle stabilizing muscles (a good thing), less strain on the lower trapezius muscles, less upper body pain, and better typing performance. The authors of the study recommend further studies to identify how standing affects more complex computer tasks over longer work sessions in symptomatic workers.

Another type of desk that is available is a treadmill desk. In one study, researchers found that treadmill desk use resulted in less upper limb pain when compared with  seated desk use, as well as healthier muscle performance from the low back paraspinal muscles, wrist extensor muscles, external abdominal obliques, lower trapezius, and anterior deltoids.

What about the trend of having a small cycling device under the desk? In a 2019 study, researchers observed that participants performed better on typing tasks when cycling, especially at greater intensity. Doctors of chiropractic are frequently asked about sit/stand desk options, with or without lower limb exercising. A common answer is to mix it up, sit or stand as needed, and vary the level of under-the-desk exercise depending on how you feel. These studies support that standing, walking, and/or cycling may be a healthier option than the traditional sit-only, sedentary desk.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic Care of the Elderly with Neck Pain

21 Sep

One-in-five adults over the age of 70 suffer from neck pain, which can dramatically affect their overall quality of life. So how effective is chiropractic care for a senior’s neck pain?

A 2019 study published in the journal Chiropractic & Manual Therapies surveyed 288 Australian chiropractors and found that individuals over 65 years of age account for nearly a third (28.5%) of total patient volume.

Of these elderly patients, nearly half (46%) sought treatment for neck pain, often with co-existing dizziness and headaches. The researchers found that this group of senior patients also has a fear of falling, which affected their ability to live independently.

The doctors of chiropractic in the survey reported they often approached treatment for seniors with neck pain using a combination of manual therapies (including spinal manipulation, instrument adjusting, mobilization, and active/passive stretches), modalities (ice/heat, ultrasound, electronic stimulation), specific exercises, and self-management recommendations to reduce pain and improve function in the neck and upper back.

Another benefit of a conservative treatment approach like chiropractic care for an older patient is that it does not involve over-the-counter or prescription medications, which can have undesirable side effects or interactions with other drugs the elderly patient may be taking.

In fact, a March 2020 study published in the journal Pain Medicine reported that patients who received chiropractic treatment for a musculoskeletal condition, like neck pain, were significantly less likely to fill a prescription for an opioid to manage their pain in the following year, especially if they consulted with a doctor of chiropractic first. Many of the patients in the study (nearly 99%) reported an improvement in their neck pain and associated symptoms following an average of nine treatments, though patients with both neck pain and migraines required two additional visits, on average. If you’re an older adult with new-onset or chronic neck pain, consider chiropractic care!

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Forward Head Posture and Neck Pain

13 Aug

Neck pain is one of the most common complaints that drive patients to seek chiropractic care. Sometimes the cause of injury is a known traumatic event, but in many cases, neck pain is the result of wear and tear from poor posture—forward head posture in particular.

The head, which weighs 10-11 lbs. (4.5-5 kg), typically rests above the shoulders. When an individual’s head leans forward to look at a computer screen or to look downwards at their smartphone/tablet, the muscles in the rear of the neck and upper back/shoulders need to work harder to keep the head upright.

Experts estimate that for each inch (2.54 cm) of forward head posture, the head feels about 10 lbs. heavier to the muscles that attach to the back of the head and neck. To illustrate this, pick up a 10-pound object like a bowling ball and hold it close to your body. Then, hold it away from your body with your arm outstretched and feel how much heavier it seems and the strain it places on your body to maintain that position for even a short time.

In the short term, forward head posture is something the body can manage, but over time, the muscles can fatigue and the strain can injure the soft tissues in the back of the neck, shoulders, and upper back. To adapt, some muscles may become stronger (and some may atrophy), the shoulders can roll forward, the cervical curve can straighten, etc. Researchers have observed that forward head posture can also reduce neck mobility, especially with rotation and forward flexion movements. While these changes can lead to several negative health issues, neck pain is perhaps the most obvious and common.

When a patient presents for chiropractic care for neck pain, postural deficits will likely need to be addressed to achieve a satisfactory outcome. This can be achieved with manual therapies to restore proper motion in the affected joints and with exercises to retrain the muscles that may have become deconditioned. Additionally, a patient will need to develop better postural habits, especially when interacting with their electronic devices. While the process can take time, the good news is that it’s possible to reduce forward head posture, which can also lower the risk for neck pain recurrence.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Neck Pain Among Office Workers

23 Jul

Neck pain is the second most common reason patients seek chiropractic care, and it’s particularly a problem with office workers. One study estimated that neck pain affects 42-69% of those who work in office environments. Many such individuals will experience recurring episodes of neck pain, and at least one in six may develop chronic, ongoing neck pain. While chiropractic offers a safe and effective way to manage neck pain, are there any steps an office worker can take to reduce the risk for neck pain in the first place?

According to one study, taking a daily walk may be an effective neck pain prevention strategy. In the study, which included 387 office workers without spinal symptoms in the previous three months, researchers asked participants to wear a pedometer and note any spinal pain symptoms over the next year.

Of the 367 participants who completed the study, 16% reported the onset of neck pain. The results showed that for every 1,000 steps a participant averaged each day, their risk for neck pain fell by 14%. The authors concluded that increasing daily walking steps is protective for the onset of neck pain in those who work sedentary jobs, and managers should formulate and test strategies to encourage walking to reduce the incidence of neck pain among employees.

What about other forms of exercise? A meta-analysis of data from two randomized control trials that included over 500 participants showed moderate-quality evidence that participating in a workplace exercise program can reduce the risk for developing a new episode of neck pain by up to 68%. In the first trial, participants performed stretching and endurance training twice a day at work and twice a day at home. The second trial involved a combination of strength, stabilization, aerobic, and body awareness exercises that included health information, ergonomic training, and stress management training three times a week for one hour over a nine-month time frame.

While it’s not possible to completely avoid a condition like neck pain, the evidence suggests that regularly engaging in physical activity may substantially lower the risk. For those who do develop neck pain, it’s important to seek chiropractic care as soon as possible, which may lead to a faster resolution of symptoms and reduce the risk for both neck pain recurrence and chronic neck pain.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Headaches May Suggest a More Severe Concussion

13 Jan

Cervical dysfunction is often a cause or contributing factor of headaches, especially those that occur following a sports injury, slip and fall, or motor vehicle collision. The results of a 2019 study suggest that headaches may also indicate when a patient has a severe traumatic brain injury (TBI).

In the study, researchers asked 121 children with a history of TBI to fill out a questionnaire called the Sports Concussion Assessment Tool (SCAT). A higher score on the SCAT is indicative of a more severe TBI. Among the participants, the SCAT revealed that a third (40) reported headaches following their injury. When the researchers compared the SCAT scores of the kids with post-TBI headaches and those without headaches, they found that the participants who experienced headaches scored five times higher (median score 45.5 vs. 9). These children also performed worse on cognitive assessments involving color naming, matrix reasoning, letter sequencing, and letter switching.

The authors concluded that when headaches are associated with TBI, higher symptom scores (i.e. more severe symptoms) for ALL other symptom categories (sleep, mood, sensory, and cognitive domains) can be expected. In addition, those with headaches also tested worse on neurocognitive examinations.

Interestingly, a study that included a wider age range reported that headache “is consistently the most common symptom following concussion and occurs in over 90% of athletes with sport-related concussion,” which is much higher than the 33% found in the above- mentioned study.

Another study that analyzed information from two large databases found that patients who are hospitalized for headache symptoms associated with TBI are two times more likely to experience more frequent or worse headache symptoms over the following decade. Thus, the worse the initial TBI, the more likely headaches will persist or worsen.

These studies suggest that when an individual suffers a TBI from a sports injury, slip and fall, or car accident AND they have headaches, their condition may be more severe and may require more specialized care or intensive treatment to achieve a successful outcome. These injuries can also affect the cervical region, which may explain why patients with TBI benefit from many of the same treatment approaches doctors of chiropractic use to treat whiplash associated disorder patients.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.